Keratoconjunctivitis

Dysfunction may be caused by aging, systemic inflammatory diseases, a decrease in androgen hormones, surgery, ocular surface diseases (such as herpes zoster), systemic diseases, or medications that affect the efferent cholinergic nerves. Decreased tear secretion produces an inflammatory response on the ocular surface called keratoconjunctivitis sicca. This inflammation is now a target for new medications that treat dry eye.29,30... 

Keratoconjunctivitis sicca Dryness of conjunctiva and cornea a component of Sjogren s syndrome. 

The carbomer polymeric gel base itself has been used successfully to treat moderate to severe cases of dry eye (keratoconjunctivitis sicca) [282]. The dry eye syndrome is usually characterized by deficiency of tear production and, therefore, requires frequent instillation of aqueous artificial tear eyedrops to keep the corneal epithelium moist. The gel base applied in a small amount provides a prolonged lubrication to the external ocular tissues, and some patients have reduced the frequency of dosing to control their symptoms to three times a day or fewer. 

Luck J, Kaye SB. 1989. An unrecognized form of hydrogen sulphide keratoconjunctivitis. BrJInd Med 46 748-749. 

The answer is b. (Hardman, p 1203.) Trifluridine inhibits viral activity in HSV types 1 and 2, CMV, vaccinia, and perhaps adenovirus. It acts as a viral DNA synthesis inhibitor by irreversibly blocking thymidylate synthetase. Trifluridine triphosphate is a competitive inhibitor of thymidine triphosphate accumulation into DNA It is used in the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis caused by HSV 1 and 2. 

A more recent report shows clear sulfonamide-induced idiosyncratic responses in dogs (mostly Dobermans) that encompasses fever, arthropathy, blood dyscrasias (neutropenia, thrombocytopenia, or hemolytic anemia) hepatotoxicity, skin eruptions, uveitis, and keratoconjunctivitis sicca [65], These symptoms became apparent as soon... 

A number of ocular surface disorders collectively termed as Dry Eye Syndromes have also been associated with the conjunctiva. For example, a deficiency and/or imbalance in compositions of the tear film is often found on the ocular surface during keratoconjunctivitis sicca. Since the conjunctiva plays a direct role in the maintenance of the tear fluid stability via secretion of mucin [1] by its resident goblet cells [4] and basal fluid secretion driven by electro-osmotic gradients across the tissue [3], the conjunctiva is a well deserved, but not intensively studied, target of interest in research efforts aimed against combating Dry Eye Syndromes. 

Khellin (32) Cromolyn sodium (33) Chromone derivative Vernal keratoconjunctivitis, vernal conjunctivitis, and vernal keratitis... 

Exposure to levels above 50 ppm for 1 hour can produce acute conjunctivitis with pain, lacrimation, and photophobia in severe form, this can progress to keratoconjunctivitis and vesiculation of the corneal epithelium. Prolonged exposure to 50 ppm also causes rhinitis, pharyngitis, bronchitis, and pneumonitis. 

Mustard gas keratitis or Sjogren s keratoconJunctivitis Top ca steroids are not effective. 

Infections Treatment of superficial ocular infections involving the conjunctiva or cornea (eg, conjunctivitis, keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, blepharoconjunctivitis, acute meibomianitis, dacryocystitis) caused by strains of microorganisms susceptible to antibiotics. 

Viral infection, especially epidemic keratoconjunctivitis (EKC), more often is associated with a follicular conjunctivitis, a serous conjunctival discharge, and preuricular lymphadenopathy. The exceptionally contagious organism causing EKC is not susceptible to antiviral therapy at this time. 

Primary keratoconjunctivitis and recurrent epithelial keratitis caused by herpes simplex virus types 1 and 2. 

Efficacy In other conditions The clinical efficacy in the treatment of stromal keratitis and uveitis caused by herpes simplex or ophthalmic infections caused by vaccinia virus and adenovirus, or in the prophylaxis of herpes simplex virus keratoconjunctivitis and epithelial keratitis has not been established by well-controlled clinical trials. Not effective against bacterial, fungal, or chlamydial infections of the cornea or trophic lesions. 

Intravenous acyclovir is used in the treatment of herpes simplex encephalitis, neonatal HSV infection, and mucocutaneous HSV infection in immunocompromised individuals. Acyclovir ointment is used in the treatment of initial genital herpes but is not effective for recurrent disease. Ophthalmic acyclovir formulations, although not available in the United States, are effective in the treatment of herpes keratoconjunctivitis. 

Trifluridine is administered as a topical ophthalmic solution for the treatment of primary keratoconjunctivitis and recurrent keratitis due to HSV-1 or HSV-2. It is not effective in the prophylaxis of these infections however, it is effective in treating patients who were unresponsive or intolerant to topical idoxuridine or vidarabine. 

The principal use of vidarabine is in the treatment of HSV keratoconjunctivitis. It is also used to treat superficial keratitis in patients unresponsive or hypersensitive to topical idoxuridine. 

Allergic reactions, alopecia, chest pain, conjunctivitis, diarrhea, diplopia, dizziness, dry mouth, dyspnea, dyspepsia, eye fatigue, hypertonia, keratoconjunctivitis, keratopathy, kidney pain, lid margin crustingor sticky sensation, nausea, pharyngitis, tearing, urticaria... 

Treatment of vernal keratoconjunctivitis, conjunctivitis, and keratitis Ophthalmic 1-2... 

I Unlabeled Uses Treatment of bacterial blepharitis, blepharoconjunctivitis, bacterial keratitis, keratoconjunctivitis... 

It is used in herpes simplex keratoconjunctivitis in 0.1 to 0.5% solution/eye ointment applied one to two hourly. 

Trifluridine (trifluorothymidine) is a fluorinated pyrimidine nucleoside that inhibits viral DNA synthesis in HSV-1, HSV-2, CMV, vaccinia, and some adenoviruses. It is phosphorylated intracellularly by host cell enzymes, and then competes with thymidine triphosphate for incorporation by the viral DNA polymerase (Figure 49-3). Incorporation of trifluridine triphosphate into both viral and host DNA prevents its systemic use. Application of a 1% solution is effective in treating keratoconjunctivitis and recurrent epithelial keratitis due to HSV-1 or HSV-2. Cutaneous application of trifluridine solution, alone or in combination with interferon alfo, has been used successfully in the treatment of acyclovir-resistant HSV infections. 

Cyclosporine is used to prevent organ rejection after tissue transplantation. It is also used for rheumatoid arthritis, psoriasis and dry eyes (keratoconjunctivitis sicca). For... 

Patients with severe keratoconjunctivitis sicca are at definite risk of this complication, and the addition of phosphate-containing eye-drops tilted the precariously balanced situation toward precipitation of calcium in the cornea and bandage contact lens. Acetate-containing rather than phosphate-containing glucocorticoid eye drops may be a safer alternative in patients with such predisposing factors. 

Trifluridine Viroptic Local (ophthalmic] administration for treatment of herpes simplex keratitis and keratoconjunctivitis... 

Antiviral Efficacy and Clinical Use. Trifluridine (Viroptic) is administered by eye drops to treat local eye infections associated with herpes simplex virus that is, herpes virus-related keratitis and keratoconjunctivitis.42... 

Antiviral Efficacy and Clinical Use. Vidarabine (Vira-A) was the first systemic agent used to treat herpesvirus infections, including CMV, herpes simplex virus, and varicella-zoster virus.42 In the past, this drug was administered by continuous intravenous infusion to treat severe systemic infections caused by these viruses, but systemic use of vidarabine has been replaced by safer and less toxic agents. Vidarabine is currently used primarily to treat local viral infections of the eye (e.g., herpes simplex keratoconjunctivitis) it is applied topically by ophthalmic ointment to treat these infections. 

Trifluridine [try FLOO ri deen] has replaced the earlier drug, idoxuridine [eye dox Yoor i deen], in the topical treatment of keratoconjunctivitis due to herpes simplex viruses. Like idoxuridine, this pyrimidine analog is incorporated into the viral DNA to disrupt its function. 

Olfactory fatigue, paralysis of olfactory nerve. Respiratory irritation, pneumonia from prolonged exposure, acute conjunctivitis, pain lacrimation, photophobia progressing to keratoconjunctivitis, vesiculation of the corneal epithelium,... 

The Navy proposes to set a SEAL 1 of 10 ppm and a SEAL 2 of 20 ppm for hydrogen sulfide. These levels are based on eye irritation reported at concentrations ranging from 5 to 30 ppm, particularly with coexposure to other chemicals or eye irritants that could lower the threshold for irritation. The Navy notes that evacuation should be considered if eye irritation becomes unbearable at hydrogen sulfide concentrations between SEAL 1 and SEAL 2, and that continued exposure could result in more permanent ocular changes, including keratoconjunctivitis and vesiculation of the corneal epithelium. 

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